Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Student Research Committee, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
PLoS One. 2021 Dec 8;16(12):e0260667. doi: 10.1371/journal.pone.0260667. eCollection 2021.
Antibiotic-associated diarrhea (AAD) is a major hospital problem and a common adverse effect of antibiotic treatment. The aim of this study was to investigate the prevalence of the most important bacteria that cause AAD in hospitalized patients.
PubMed, Web of Science and Scopus databases were searched using multiple relevant keywords and screening carried out based on inclusion/exclusion criteria from March 2001 to October 2021. The random-effects model was used to conduct the meta-analysis.
Of the 7,377 identified articles, 56 met the inclusion criteria. Pooling all studies, the prevalence of Clostridioides (Clostridium) difficile, Clostridium perfringens, Klebsiella oxytoca, and Staphylococcus aureus as AAD-related bacteria among hospitalized patients were 19.6%, 14.9%, 27%, and 5.2%, respectively. The prevalence of all four bacteria was higher in Europe compared to other continents. The highest resistance of C. difficile was estimated to ciprofloxacin and the lowest resistances were reported to chloramphenicol, vancomycin, and metronidazole. There was no or little data on antibiotic resistance of other bacteria.
The results of this study emphasize the need for a surveillance program, as well as timely public and hospital health measures in order to control and treat AAD infections.
抗生素相关性腹泻（AAD）是医院的主要问题，也是抗生素治疗的常见不良反应。本研究旨在调查住院患者中引起 AAD 的最重要细菌的流行情况。
从 2001 年 3 月至 2021 年 10 月，我们使用多个相关关键字在 PubMed、Web of Science 和 Scopus 数据库中进行了搜索，并根据纳入/排除标准进行了筛选。使用随机效应模型进行荟萃分析。
在 7377 篇确定的文章中，有 56 篇符合纳入标准。汇总所有研究，住院患者中与 AAD 相关的细菌中艰难梭菌（梭状芽胞杆菌）、产气荚膜梭菌、产酸克雷伯菌和金黄色葡萄球菌的流行率分别为 19.6%、14.9%、27%和 5.2%。与其他大陆相比，这四种细菌在欧洲的流行率更高。艰难梭菌对环丙沙星的耐药性估计最高，对氯霉素、万古霉素和甲硝唑的耐药性最低。其他细菌的抗生素耐药性数据很少或没有。
本研究结果强调了需要进行监测计划，以及及时采取公共和医院卫生措施，以控制和治疗 AAD 感染。
